Provider Demographics
NPI:1700497872
Name:LUCAS, LINDA ANNE
Entity type:Individual
Prefix:
First Name:LINDA
Middle Name:ANNE
Last Name:LUCAS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:120 SAWYER RD
Mailing Address - Street 2:
Mailing Address - City:WILMOT
Mailing Address - State:NH
Mailing Address - Zip Code:03287-4327
Mailing Address - Country:US
Mailing Address - Phone:603-768-5500
Mailing Address - Fax:
Practice Address - Street 1:134 HALL ST
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:NH
Practice Address - Zip Code:03301-3470
Practice Address - Country:US
Practice Address - Phone:603-224-4540
Practice Address - Fax:603-228-7384
Is Sole Proprietor?:No
Enumeration Date:2020-08-12
Last Update Date:2020-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH133225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics